Medical society leader unveils doctors' plan to fix Cooper Green

The exterior of Cooper Green Mercy Hospital is shown in Birmingham, Ala., Friday, March 23, 2012. (The Birmingham News/Mark Almond)

BIRMINGHAM, Alabama -- In a sometimes raucous community forum this evening, the Jefferson County Medical Society president-elect laid out a plan to fix what his group has called the "abject failure" surrounding the downsizing of Cooper Green Mercy Hospital.

Dr. Gregory Ayers said the society endorses a plan to hand over the county's $40-million per year tax-funded indigent care fund to the state department of health to create a health insurance plan for Jefferson County's poor.

"The time is right for a new system," Ayers said to a standing-room only crowd of about 60 at the Five Points West Public Library. "The new system must accomplish three things: first, access to care with heavy emphasis on primary care, number two, that it be devoid of politics and, three, it must be cost-efficient."

Ayers said the society -- which represents 2,300 doctors in the county -- has talked to Alabama Department of Public Health state health officer Don Williamson and the plan is actuarially feasible -- but it must get legislative approval. The plan would involve the state health department subcontracting with a third party such as Blue Cross/Blue Shield, Viva Health, or even Medicaid, he said.

The plan, he envisions, would include a centralized clinic maintained at Cooper Green, but would give patients some freedom to choose doctors, he said.

Although his speech drew polite applause, during a question-and-answer session Ayers was loudly confronted by one audience member.

Journalist Vickii Howell with Birmingham View was moderator and organizer of the event which featured Ayers, Dr. Mark Wilson, head of the Jefferson County Health Department and Dr. Sandral Hullett, former medical director and CEO of the hospital. Amid financial crisis, the hospital shut down its inpatient operations Jan. 1 and now operates as an urgent and primary care facility.

Wilson said the main problem is the transition, due to contractual uncertainty, led to the loss of primary caregivers. Recent hires of two nurse practitioners put the number of primary caregivers at seven, he said. But it used to be 12, a number which at the time was inadequate, he said.

Currently, patients making an appointment with a primary caregiver must wait until October, he said.

Wilson, while not endorsing any particular plan, laid out the options as these:

Maintain a full scale hospital with outpatient services. "We're probably not going to get that back" without more money than what the indigent care fund brings.

Do what the medical society is proposing and create an insurance plan like Medicaid. With 16 percent -- or 105,000 -- of the people in the county without any insurance or Medicaid, the math means there's $428 per person per year. "That would be a very limited plan."

Create a scaled down version of a hospital with a few beds.

Try and do what is being done now only make it work with more primary care.

"Right now the county needs to be flexible and get creative ways to get primary care," he said. "That's the biggest need."

Hullett, whom the Jefferson County personnel board has ordered reinstated after her layoff in December, said she was an advocate of a health care authority, an idea that has been batted around for some time and seems to have some political traction.

"But in the meantime, this is what we have," she said.

Ayers said the medical society's concern with a health care authority is that it runs the danger of being too political. But in the end, Ayers said the society hasn't ruled out whatever good idea the community supports.

"The medical side is not vested in any one solution," he said.

Hullett said better outreach -- through churches, schools and library forums like the one this evening -- to teach people how to best use the medical system would go a long way to easing confusion right now.

Howell promised more forums in the future to keep the issue alive.

"This is an important story," she said. "Really this is not just a story. This is about people's lives."